The Health in Mental Health

Schizophrenia isn’t fatal. Depression itself won’t kill a person. In fact, psychiatric illnesses are altogether absent from official lists of top causes of death.

Then why do people with severe mental illnesses have a 25-year shorter lifespan than the general population? That question has driven longstanding research by William Eaton, PhD.

“Repeatedly, we find that people with schizophrenia have higher rates of mortality; but they’re not dying from schizophrenia. They are dying from failing to present with, and get treatment for cardiovascular disease, cancer and diabetes,” says Eaton, PhD, the Sylvia and Harold Halpert Professor and Chair in Mental Health.

Eaton reviewed a quarter-century’s worth of literature on four common mental disorders and summarized their effects on mortality for the 2012 book Public Mental Health. Depressive disorder, he reveals, raises the risk for mortality by 70 percent. “Our research was among the first to show in population-based samples that a history of depressive disorder was associated with a raised risk for Type-II diabetes, cardiovascular disease and stroke,” Eaton says.

Eaton describes all-too-common scenarios. An individual with schizophrenia consults with a psychiatrist about his mental disorder instead of visiting a primary care physician who would diagnose and treat his hypertension. Likewise, a patient with major depressive disorder who has suicidal ideation might not be asked by her primary care practitioner if she is taking her cholesterol medication.

Both depression and schizophrenia are known to influence behaviors associated with risk factors for a range of chronic medical conditions. For example, a lack of regular exercise combined with psychoactive drugs can lead to weight gain and contribute to obesity and diabetes.

The bottom line: Even though individuals with mental illness have high suicide rates, especially those with depressive disorders, most die from largely preventable diseases, and die earlier from those diseases than others.